Last update June 4, 2021
Very Low Risk
Prednisolone is the active form of prednisone. Its effects is mainly glucocorticoid.
Excreted into breast milk in non-significant amount (Ryu 2018, Greenberger 1993, Ost 1985, Berlin 1979, Katz 1975, McKenzie 1975) and no problems reported in breastfed infants whose mothers who took it even for long periods of time (Moretti 2003, Muñoz 2001, Nyberg 1998, Ito 1993), nor at doses of 40 to 60 mg daily (Izumi 2014, Gan 2012, Westermann 2012).
On long term treatments or in high doses some authors recommend to wait for 4 hours until the next nurse to minimize the transfer of drug to breast milk (Sammaritano 2020 & 2014, Götestam 2016, Damas 2015, van der Woude 2015 & 2010, Durst 2015, Huang 2014, Bae 2012, Habal 2012, Van Assche 2010, Heetun 2007).
At high doses, intra-articular treatment with other steroid drugs (Methylprednisolone, Triamcinolone) have transiently affected milk production (Babwah 2013, McGuire 2012).
Steroids administered before delivery may delay initiation of phase II of Lactogenesis ("milk come in") and decrease milk production in the first postpartum week (Henderson 2008).
Steroid drugs are commonly used for Pediatric treatment with no side effects when infrequently used and for short-time periods.
Several medical societies, experts and expert consensus, consider the use of prednisone/prednisolone to be safe during breastfeeding (LactMed, Hale, Nguyen 2016, Götestam 2016, Flint 2016, Noviani 2016, Shah 2016, McConnell 2016, Bordini 2016, Huang 2016 & 2014, Briggs 2015, Schaefer 2015, Damas 2015, van der Woude 2015 & 2010, Durst 2015, Schulze 2014, Yarur 2013, Bae 2012, Habal 2012, Jain 2011, Van Assche 2010, Mottet 2009, Heetun 2007, Østensen 2007, N.Asthma 2004, Janssen 2000, Goldsmith 1989, Needs 1985).
American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).
List of WHO essential medicines: compatible with breastfeeding (WHO / UNICEF 2002).
We do not have alternatives for Prednisolone since it is relatively safe.
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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Thank you for helping to protect and promote breastfeeding.
e-lactancia is a resource recommended by Asociación Española de Bancos de Leche Humana of Spain
Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM